Presentation (CTI)

OBJECTIVES: To analyze the role of decentralized Health Economics Units (Núcleos de Economia da Saúde - NES) in strengthening evidence-based decision making within Brazil’s Unified Health System (SUS), and to assess their potential as a scalable strategy for improving efficiency, equity, and sustainability in health systems.
METHODS: This study adopts a descriptive and analytical approach based on the implementation experience of NES across Brazilian states and municipalities. Data sources include institutional reports, technical documents, and practical experiences related to budgeting, cost management (e.g., national costing systems), and procurement processes. The analysis explores how NES contribute to the use of economic evidence in planning and decision making, as well as key challenges related to governance, workforce capacity, and system integration.
RESULTS: The implementation of NES has contributed to increased use of health economic tools in local decision making, particularly in cost analysis, budget monitoring, and procurement optimization. Evidence indicates improved integration between planning, finance, and service delivery areas, as well as enhanced capacity to interpret and use data from national health information systems. However, challenges remain, including limited technical capacity, variability in institutionalization across regions, and difficulties in integrating fragmented data systems. Additionally, political and organizational factors influence the sustainability of these units.
CONCLUSIONS: Decentralized health economics units represent a promising strategy to bridge the gap between evidence generation and decision making in health systems. While the Brazilian experience demonstrates their potential to improve efficiency and governance, scaling and sustaining this model requires continued investment in capacity building, institutional support, and system integration. These findings are particularly relevant for low- and middle-income countries seeking to strengthen health system performance through localized economic analysis.